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Elucidating How Heavy Substance Use Impacts Affect and Cognition of Adolescents /

Abstract

This body of research elucidates the complex relationship among premorbid functioning, brain development, and the effects of alcohol and marijuana use during adolescence. Given the high rates of alcohol and marijuana use among youth, these findings have far-reaching, important implications in academic, occupational, and personal settings. Chapter 1 indicates that heavy drinking youth with recent alcohol exposure show much greater emotional responses and poorer distress tolerance to a challenging cognitive task. Importantly, their affective responses diminish with sustained abstinence. It is possible that the combination of elevated negative affect and low distress tolerance during early abstinence may heighten risk for progression to an alcohol use disorder or result in return to use. The capacity to withstand aversive internal states is integral to daily functioning, so reductions in emotional reactivity with abstinence may contribute to academic and social improvements. Chapter 2 identifies deficits among heavy drinking youth during early abstinence and following four weeks of abstention in prospective memory, cognitive switching, inhibition task accuracy, verbal memory, visuospatial construction, reading, and vocabulary. Given teens' comparable 5th grade math and language arts standardized test performance, the study suggests alcohol-related influences on several underlying brain systems that may (1) arise in heavy social drinkers prior to the onset of alcohol abuse or dependence or (2) take longer than four weeks to recover. Chapter 3 extends the findings of Chapter 2 by introducing two more groups of adolescents: protracted marijuana users and those with concomitant use of both alcohol and marijuana. The study suggests that relative weakness in cognitive flexibility, verbal recall, semantic clustering, and reading skills may be related to heavy alcohol use during adolescence, whereas poorer task accuracy, verbal memory, and psychomotor speed may be associated with regular marijuana use. Further, working memory may be particularly impacted by concomitant use of marijuana and alcohol. These studies contribute to methods for measuring changes on important affective and cognitive domains associated with heavy alcohol and/or marijuana use during adolescence. Possible decrements may significantly impact adolescents' daily experiences, and with knowledge of these deficits, educators, parents, and clinicians may be able to improve outcomes for these teens

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